Pericardial fat pads
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View Henry Knipe's current disclosuresAt the time the article was last revised Liz Silverstone had no financial relationships to ineligible companies to disclose.
View Liz Silverstone's current disclosures- Pericardial fat pad
- Pericardial fat pads
Pericardial fat pads are normal adipose tissue masses that lie in the cardiophrenic angles and straddle the pericardium as they are derived from both epicardial fat and epipericardial fat, the latter being adherent and external to the parietal pericardium. Fat pads are more prominent in obese patients.
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Pathology
They can be affected by fat necrosis, see: epipericardial fat necrosis and inflammation directly causing coronary atheromatous disease 6.
Radiographic features
Plain radiograph
mass or hazy opacity in the cardiophrenic angle
cardiac and diaphragmatic silhouettes usually visible
CT
easily differentiates pericardial fat pad from pathology other than a lipoma
Differential diagnosis
At times they are large enough to simulate pathology and can be mistaken for:
lipoma or another pericardial tumor such as thymolipoma
pericardial cyst (especially on the right)
epicardial lymphadenopathy
Quiz questions
References
- 1. McLoud TC. Thoracic Radiology: The Requisites: The Requisites (Requisites in Radiology). Mosby. ISBN:B005DXPW0W. Read it at Google Books - Find it at Amazon
- 2. Pope TL. Harris & Harris' Radiology of Emergency Medicine. Lippincott Williams & Wilkins. (2012) ISBN:145110720X. Read it at Google Books - Find it at Amazon
- 3. Grant, Griffin. Grainger & Allison's Diagnostic Radiology Essentials. Churchill Livingstone. ISBN:B00CC6IA3Y. Read it at Google Books - Find it at Amazon
- 4. Wong CX, Ganesan AN, Selvanayagam JB. Epicardial fat and atrial fibrillation: current evidence, potential mechanisms, clinical implications, and future directions. (2017) European heart journal. 38 (17): 1294-1302. doi:10.1093/eurheartj/ehw045 - Pubmed
- 5. Stephan MS, Stephan RW, Stephan LL, Stephan CL, Stephan PEOB, Stephan AJT. Effects of Weight Loss on Pericardial Fat and Left Ventricular Mass Assessed with Cardiac Magnetic Resonance Imaging in Morbid Obesity. (2011) doi:10.4236/ijcm.2011.24062
- 6. Bertaso AG, Bertol D, Duncan BB, Foppa M. Epicardial fat: definition, measurements and systematic review of main outcomes. (2013) Arquivos brasileiros de cardiologia. 101 (1): e18-28. doi:10.5935/abc.20130138 - Pubmed
Incoming Links
- Pulmonary pseudotumour
- Moguls of the heart
- Point-of-care ultrasound (curriculum)
- Epipericardial fat necrosis
- Cardiothoracic ratio
- Cardiophrenic angle lesions
- Morgagni hernia
- Focused Assessment with Sonography for Trauma (FAST) scan
- Assessment of cardiomediastinal contours on chest x-ray (approach)
- Pericardial cyst
- Thymolipoma
Related articles: Anatomy: Thoracic
- thoracic skeleton
- thoracic cage
- thoracic spine
- articulations
- muscles of the thorax
- diaphragm
- intercostal space
- intercostal muscles
- variant anatomy
- spaces of the thorax
- thoracic viscera
- lower respiratory tract
-
heart
- cardiac chambers
- heart valves
- cardiac fibrous skeleton
- innervation of the heart
- development of the heart
- cardiac wall
-
pericardium
- epicardium
- epicardial fat pad
- pericardial space
- oblique pericardial sinus
- transverse pericardial sinus
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pericardial recesses
- aortic recesses
- pulmonic recesses
- postcaval recess
- pulmonary venous recesses
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- myocardium
- endocardium
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pericardium
- esophagus
- thymus
- breast
- arterial supply of the thorax
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thoracic aorta (development)
-
ascending aorta
-
aortic root
- aortic annulus
-
coronary arteries
- coronary arterial dominance
- myocardial segments
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left main coronary artery (LMCA)
- ramus intermedius artery (RI)
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circumflex artery (LCx)
- obtuse marginal branches (OM1, OM2, etc))
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left anterior descending artery (LAD)
- diagonal branches (D1, D2, etc)
- septal perforators (S1, S2, etc)
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right coronary artery (RCA)
- conus artery
- sinoatrial nodal artery
- acute marginal branches (AM1, AM2, etc)
- inferior interventricular artery (PDA)
- posterior left ventricular artery (PLV)
- congenital anomalies
- sinotubular junction
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aortic root
- aortic arch
- aortic isthmus
- descending aorta
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ascending aorta
- pulmonary trunk
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thoracic aorta (development)
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- superior vena cava (SVC)
- inferior vena cava (IVC)
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coronary veins
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cardiac veins which drain into the coronary sinus
- great cardiac vein
- middle cardiac vein
- small cardiac vein
- posterior vein of the left ventricle
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cardiac veins which drain into the coronary sinus
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- bronchial veins
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- lymphatics of the thorax
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